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Comment by leereeves | Hacker News Reader

> and, well, they’re frankly not spending enough time with each patient per appointment.

Many doctors would agree with you. They're under enormous pressure to work faster from both non-medical administrators and non-medical reimbursement decision makers.

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Neither of those groups seem to be in a rush to buck the AMA workflows that lead to this.

My company, my insurance company, my pharmacy insurance company, the required health startup I have to use, my doctor and I all get to decide whether I can take a commonly prescribed medicine that i need. Theres way way too many parties in that decision. The ama isn't the problem that's driving wedges between my doctor and me.

Also my insurance-mandated 20 minute time limit on appointments. Then I can only ask about one thing in that 20 minutes. If I have another thing, I have to make another appointment for it, because that's the only way insurance will cover my visit.

Doctors have an ethical and professional responsibility to demand the appropriate amount of time to see patients - or walk.

You have a personal responsibility to demand the appropriate amount of time to be seen by your provider - or walk.

As the only industry group of substantial size or true recognition by legislators, the AMA’s responsibility to lean on each level of this system (through direct lobbying or government intervention) is large, and largely being abdicated.

Or... perhaps... capital interests are stronger.

Perhaps they’re a lot of the same people.

I think that's possible. Maybe we should limit the ability of capital to exert power somehow.

Any historically successful ideas?

(Any ideas that have gained traction in other pleasant countries to live in?)

US had a marginal tax rate that went up to 90%. The nordics have strong progressive taxation. Wealth taxes too, like the ISF in France or the taxes in Switzerland or Spain. Wage compression, especially by increasing minimum wage alongside stronger social programs and support have shown to reduce inequality.

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